On board blood, plasma add critical level of care on flights

Jul. 19, 2013

Registered nurse and paramedic Tina Baysinger rearranges the back of the Life Flight helicopter, which will have blood and plasma stocked on board by the end of the month. / Bryon Houlgrave/The Register

Written by

Estela Villanueva-Whitman

Special to The Register

Iowa Methodist Medical Center Life Flight paramedic Rick Kallemeier will be part of the only hospital air transport crew in Iowa that will provide blood and plasma on emergency calls. / Bryon Houlgrave/The Register

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By the end of the month, Life Flight crews will be stocking blood and plasma on board every time the medical helicopter launches from its base at Iowa Methodist Medical Center.

Due to strict regulations and expense, few medical flight programs nationwide carry the products. However, more advanced critical care transport teams are seeing the value of doing so. Life Flight is the first in Iowa to implement a blood program.

“It will decrease the amount of time before we get it administered and reduce our reliance on the outside facilities’ resource,” said Life Flight manager Michael Zweigart.

While metro hospitals store hundreds of units of blood, smaller facilities carry from zero to four units at a time. Taking one or two of those further reduces that resource, Zweigart said. For plasma, the soonest referring hospitals can have it thawed and ready to use is 45 minutes.

“We were kind of to a point where we didn’t like using the other facilities’ resources. We felt like we were stealing from them. They were always helpful and they always gave it to us,” he said.

Even if not used daily, the products will be available on every flight — between 50 to 70 trips per month.

Bleeding is a common cause of preventable death. The sooner a severely-injured patient receives blood, the better, he said, adding that the move represents the evolution of trauma care.

In the past, if providers knew in advance that blood products were needed, they could make arrangements to bring it on board. Other times, however, medics may not have been able to hold up a launch to wait for blood from the blood bank, Sidwell said.

With refrigeration units now on the same level as the helipad, crews can pack a lightweight, blue cooler with blood as they leave, without having to jump through extra hoops to get it. Blood is stored 24/7 and can be packed on ice in a cooler for 12 to 18 hours. Crews will stock two units of O negative blood as well as two units of thawed plasma.

The program is especially important in rural Iowa, where transport times are longer and supplies are limited, added flight paramedic Rick Kallemeier.

“It is a huge resource that a lot of these facilities just don’t have. The smaller hospitals don’t have the amount of blood or cells to give up on a whim,” he said.

Previously, patients would be stabilized using saline.

“With this, we’re actually giving blood on the scene or in the hospital and that’s a life-saver right there,” he said.

Kallemeier added that blood products are being used more often with Life Flight patients. Summer is the busiest time, with farm injuries and car/ATV/motorcycle accidents.

Trauma patients make up 30 percent of the total flight volume, so they won’t be the only recipients of the products. Most will be medical patients with such issues as stomach bleeds, hemorrhagic stroke or blood thinner overdose. Longer flights may take 45 minutes and some patients may already be six to 12 hours into their injury and in need of blood, Zweigart pointed out.

The Life Flight team was previously qualified to handle and administer blood products, but additional training was required as part of the project. UnityPoint Health-Des Moines also invested about $20,000 to purchase and install refrigeration units.

Life Flight officials began discussing the project more than two years ago and teamed up with the Iowa Methodist Medical Center blood bank as well as the hospital’s trauma services. Two facilities that offer blood products through their medical flight programs, the Mayo Clinic and Vanderbilt LifeFlight, also provided technical support.